HYPERBARIC OXYGEN THERAPY: MECHANISMS, CLINICAL APPLICATIONS, AND FUTURE DIRECTIONS

Keywords: Hyperbaric Oxygenation, Angiogenesis, Radiation Injuries, Neurocognitive Rehabilitation , Tissue Repair

Abstract

Objective: To synthesize recent evidence (2020-2025) regarding Hyperbaric Oxygen Therapy (HBOT) mechanisms, effectiveness, safety, and new applications.

Methods: A systematic literature review was conducted (PubMed, Scopus, Web of Science, Cochrane) using the terms "hyperbaric oxygen therapy" and primary indications (e.g., diabetic foot ulcer, radiation injury), mechanisms (e.g., angiogenesis), and safety. Boolean operators were used to limit searches. Peer-reviewed literature (2020-2025) adhering to inclusion criteria was title/abstract screened, reviewed at full text, and data extracted. Narrative synthesis appraised findings.

Results: HBOT significantly improves diabetic foot ulcer healing (2.2 fold faster healing, 33-52% reduction in amputation risk) and radiation tissue injury (80% healing in osteoradionecrosis). HBOT reduces mortality in acute illnesses (e.g., 66%  to  23% in Fournier's gangrene) and long-term sequelae in CO poisoning (50% reduction). Promising data are available for efficacy in post-stroke recovery, post-COVID cognitive dysfunction, Parkinson's, male infertility, and early femoral head necrosis. Side effects are rare (<5%) and typically minor (e.g., ear barotrauma).

Conclusions: HBOT is effective and safe for established indications such as radiation injury and chronic wounds. New applications in oncology and neurology are promising but require further verification. The future of research is optimization and availability.

References

Albanese R, Tomaselli F, Tambasco D. The use of preoperative hyperbaric oxygen therapy (HBOT) in reduction mammaplasty: a useful algorithm to simplify choices. Aesthetic Plast Surg. 2025;49:2149-50. doi:10.1007/s00266-024-04153-4 https://pubmed.ncbi.nlm.nih.gov/38816656/

Banou E. Hyperbaric oxygen therapy effect on "kinesia paradoxa" brain circuits. Adv Exp Med Biol. 2021;1339:139-46. doi:10.1007/978-3-030-78787-5_19 https://pubmed.ncbi.nlm.nih.gov/35023101/

Borlongan CV, Hadanny A. Why provide 40 sessions of hyperbaric oxygen therapy to patients with traumatic brain injury? Med Gas Res. 2025;15:132-3. doi:10.4103/mgr.MEDGASRES-D-24-00029 https://pmc.ncbi.nlm.nih.gov/articles/PMC11515066/

Bu S, Liu W, Sheng X, et al. Hyperbaric oxygen therapy improves motor symptoms, sleep, and cognitive dysfunctions in Parkinson's disease. Dement Geriatr Cogn Disord. 2025;54:187-200. doi:10.1159/000542619 https://pubmed.ncbi.nlm.nih.gov/39571556

Cai T. Hyperbaric oxygen therapy as an adjunct treatment for glioma and brain metastasis: a literature review. Med Gas Res. 2025;15:420-6. doi:10.4103/mgr.MEDGASRES-D-24-00096 https://pubmed.ncbi.nlm.nih.gov/39923138/

Canarslan Demir K, Avci AU, Ozgok Kangal MK, et al. Hyperbaric oxygen therapy for managing cancer treatment complications: a safety evaluation. Medicina (Kaunas). 2025;61:385. doi:10.3390/medicina61030385 https://pubmed.ncbi.nlm.nih.gov/40142196/

Cao Y, Tang P, Tan H, et al. Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis. EFORT Open Rev. 2025;10:466-74. doi:10.1530/EOR-2024-0167 https://pubmed.ncbi.nlm.nih.gov/40591670/

Daniel A, Haney V, Tveit M, et al. Evaluating the effect of hyperbaric oxygen therapy to treat mastectomy skin flap ischemia in breast reconstruction: a single-institution retrospective analysis. Am J Surg. 2025;242:116110. doi:10.1016/j.amjsurg.2024.116110 https://pubmed.ncbi.nlm.nih.gov/39609143

Raizandha, M. A., Hidayatullah, F., Kloping, Y. P., Rahman, I. A., Djatisoesanto, W., & Rizaldi, F. (2022). The role of hyperbaric oxygen therapy in Fournier's Gangrene: A systematic review and meta-analysis of observational studies. International braz j urol : official journal of the Brazilian Society of Urology, 48(5), 771–781. https://doi.org/10.1590/S1677-5538.IBJU.2022.0119, https://pmc.ncbi.nlm.nih.gov/articles/PMC9388173/

Fisher SM, Sherif RD, Borab ZM, et al. Hyperbaric oxygen therapy in aesthetic medicine and anti-aging: a systematic review. Aesthetic Plast Surg. 2025;49:2534-44. doi:10.1007/s00266-024-04553-6, https://pubmed.ncbi.nlm.nih.gov/39733047

Hadanny A, Rittblat M, Bitterman M, et al. Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients - a retrospective analysis. Restor Neurol Neurosci. 2020;38:93-107. doi:10.3233/RNN-190959, https://pubmed.ncbi.nlm.nih.gov/31985478/

Joshua TG, Ayub A, Wijesinghe P, et al. Hyperbaric oxygen therapy for patients with sudden sensorineural hearing loss: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2022;148:5-11. doi:10.1001/jamaoto.2021.2685, https://pubmed.ncbi.nlm.nih.gov/34709348/

Liang XX, Hao YG, Duan XM, et al. Hyperbaric oxygen therapy for post-stroke depression: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2020;195:105910. doi:10.1016/j.clineuro.2020.105910, https://pubmed.ncbi.nlm.nih.gov/32474256/

Liu B, Wang J, Liu L, et al. Hyperbaric oxygen therapy for male infertility: a systematic review and meta-analysis on improving sperm quality and fertility outcomes. Med Gas Res. 2025;15:529-34. doi:10.4103/mgr.MEDGASRES-D-24-00153, https://pubmed.ncbi.nlm.nih.gov/40300888/

Mei S, Han Y, Yi H, et al. Exploring a new direction in targeted cancer therapy through hyperbaric oxygen therapy combined with biomedical engineering techniques. Front Oncol. 2025;15:1580515. doi:10.3389/fonc.2025.1580515, https://pubmed.ncbi.nlm.nih.gov/40552269/

Mensah-Kane P, Sumien N. The potential of hyperbaric oxygen as a therapy for neurodegenerative diseases. Geroscience. 2023;45:747-56. doi:10.1007/s11357-022-00707-z, https://pmc.ncbi.nlm.nih.gov/articles/PMC9886

Mijajlovic MD, Aleksic V, Milosevic N, et al. Hyperbaric oxygen therapy in acute stroke: is it time for Justitia to open her eyes? Neurol Sci. 2020;41:1381-90. doi:10.1007/s10072-020-04241-8, https://pubmed.ncbi.nlm.nih.gov/31925614/

Moghadam N, Hieda M, Ramey L, et al. Hyperbaric oxygen therapy in sports musculoskeletal injuries. Med Sci Sports Exerc. 2020;52:1420-6. doi:10.1249/MSS.0000000000002257, https://pubmed.ncbi.nlm.nih.gov/31876671/

Muroya D, Nadayoshi S, Kai Y, et al. Gut microbiota and hyperbaric oxygen therapy. Med Gas Res. 2025;15:548-9. doi:10.4103/mgr.MEDGASRES-D-25-00018, https://journals.lww.com/mgar/fulltext/2025/12000/gut_microbiota_and_hyperbaric_oxygen_therapy.13.aspx

Myśliwiec AP, Walatek JT, Tarnawa A, et al. Can hyperbaric oxygen therapy be used to treat children after COVID-19? A bibliographic review. Int J Environ Res Public Health. 2022;19:15213. doi:10.3390/ijerph192215213, https://pubmed.ncbi.nlm.nih.gov/36429932/

Ortega MA, Fraile-Martinez O, García-Montero C, et al. A general overview on the hyperbaric oxygen therapy: applications, mechanisms and translational opportunities. Medicina (Kaunas). 2021;57:864. doi:10.3390/medicina57090864, https://pmc.ncbi.nlm.nih.gov/articles/PMC8465921/

Resanović I, Zarić B, Radovanović J, et al. Hyperbaric oxygen therapy and vascular complications in diabetes mellitus. Angiology. 2020;71:876-85. doi:10.1177/0003319720936925, https://pubmed.ncbi.nlm.nih.gov/32638622/

Sen S, Sen S. Therapeutic effects of hyperbaric oxygen: integrated review. Med Gas Res. 2021;11:30-3. doi:10.4103/2045-9912.310057, https://pubmed.ncbi.nlm.nih.gov/33642335/

Tambasco D, Albanese R, Tomaselli F, et al. The present and future role of hyperbaric oxygen therapy in plastic surgery. Aesthetic Plast Surg. 2025;49:1583-4. doi:10.1007/s00266-024-03867-9, https://pubmed.ncbi.nlm.nih.gov/38360957/

Tanaka H, Rees J, Zhang Z, et al. Emerging indications for hyperbaric oxygen treatment: registry cohort study. Interact J Med Res. 2024;13:e53821. doi:10.2196/53821, https://pubmed.ncbi.nlm.nih.gov/39078624/

Tian M, Du W, Yang S, et al. Application and progress of hyperbaric oxygen therapy in cardiovascular diseases. Med Gas Res. 2025;15:427-34. doi:10.4103/mgr.MEDGASRES-D-24-00107, https://pmc.ncbi.nlm.nih.gov/articles/PMC12054664/

Wang H, Li Y, Shen S, et al. Hyperbaric oxygen therapy for paroxysmal sympathetic hyperactivity syndrome after brain injury: a multicenter, retrospective cohort study. Med Gas Res. 2025;15:327-31. doi:10.4103/mgr.MEDGASRES-D-24-00077, https://pubmed.ncbi.nlm.nih.gov/39829168/

Wang P, Huang Q, Liu B, et al. Oxygen therapy in the intensive care unit. Med Gas Res. 2025;15:478-87. doi:10.4103/mgr.MEDGASRES-D-24-00143, https://pubmed.ncbi.nlm.nih.gov/40300883/

Yeh HT, Lee CH. Hyperbaric oxygen therapy research: an analysis of the 100 most-cited publications from 2011 to 2020. Undersea Hyperb Med. 2022;49:519-32. doi:10.22462/07.08.2022.11, https://pubmed.ncbi.nlm.nih.gov/36446297/

Zhang Z, Zhang W, Xu Y, et al. Efficacy of hyperbaric oxygen therapy for diabetic foot ulcers: an updated systematic review and meta-analysis. Asian J Surg. 2022;45:68-78. doi:10.1016/j.asjsur.2021.07.047, https://pubmed.ncbi.nlm.nih.gov/34376365/

Zilberman-Itskovich S, Catalogna M, Sasson E, et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Sci Rep. 2022;12:11252. doi:10.1038/s41598-022-15565-0, https://pubmed.ncbi.nlm.nih.gov/35821512/

Views:

20

Downloads:

6

Published
2025-07-17
Citations
How to Cite
Małgorzata Wasilewska, Krzysztof Pietrzak, & Sebastian Polok. (2025). HYPERBARIC OXYGEN THERAPY: MECHANISMS, CLINICAL APPLICATIONS, AND FUTURE DIRECTIONS. International Journal of Innovative Technologies in Social Science, (3(47). https://doi.org/10.31435/ijitss.3(47).2025.3470